Document Detail

Transfusion support with RBCs from an Mk homozygote in a case of autoimmune hemolytic anemia following diphtheria-pertussis-tetanus vaccination.
MedLine Citation:
PMID:  12084164     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Autoimmune hemolytic anemia (AIHA) in children, although unusual, is often associated with recent infection. Several reports have identified the diphtheria-pertussis-tetanus (DPT) vaccination as a possible trigger for AIHA. STUDY DESIGN AND METHODS: Life-threatening AIHA was diagnosed in a 6-week-old infant 5 days after receiving a DPT vaccination. The patient required daily transfusion and/or exchange transfusion for 3 weeks. RBCs from an Mk homozygote were found compatible with the patient's autoantibody. Transfusion of RBCs from an Mk homozygote and later RBCs from an individual (K.T.) with a variant glycophorin, Mi.VII, were required to sustain the patient's Hb level until autoantibody production ceased, as evidenced by a fall in antibody titer and the patient's Hct returning to normal. RESULTS: The DAT was positive (3+) with only anti-C3 on presentation. An IgM cold reactive autoantibody with probable anti-Pr specificity and high thermal amplitude (37 degrees C) was identified in the serum. The DAT was no longer positive after transfusion with compatible blood. CONCLUSION: This case represents life-threatening AIHA in an infant, temporally related to a DPT injection and responsive to a combination of immunosuppression and transfusion of rare compatible blood.
Susan T Johnson; Janice G McFarland; Kevin J Kelly; James T Casper; Jerome L Gottschall
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Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  Transfusion     Volume:  42     ISSN:  0041-1132     ISO Abbreviation:  Transfusion     Publication Date:  2002 May 
Date Detail:
Created Date:  2002-06-26     Completed Date:  2002-07-15     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  0417360     Medline TA:  Transfusion     Country:  United States    
Other Details:
Languages:  eng     Pagination:  567-71     Citation Subset:  IM    
Immunohematology Reference Laboratory, The Blood Center of Southeastern Wisconsin, Children's Hospital of Wisconsin, and the Medical College of Wisconsin, Milwaukee, Wisconsin 53201-2178, USA.
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MeSH Terms
Agglutinins / biosynthesis,  immunology*
Anemia, Hemolytic, Autoimmune / etiology*
Antibody Specificity
Autoantibodies / biosynthesis,  immunology*
Autoantigens / genetics,  immunology*
Blood Transfusion*
Diphtheria-Tetanus-Pertussis Vaccine / adverse effects*
Erythrocyte Transfusion
Exchange Transfusion, Whole Blood
Glycophorin / genetics,  immunology*
Immunoglobulin M / biosynthesis,  immunology*
Infant, Newborn
MNSs Blood-Group System / genetics,  immunology*
Reg. No./Substance:
0/Agglutinins; 0/Autoantibodies; 0/Autoantigens; 0/Cryoglobulins; 0/Diphtheria-Tetanus-Pertussis Vaccine; 0/Glycophorin; 0/Immunoglobulin M; 0/MNSs Blood-Group System; 0/cold agglutinins

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